Multi-organ Abdominal Transplant Gives Preteen a New Future

Stanford Kids’s says sure to extraordinarily tough surgical procedure, discovering ingenious methods to beat roadblocks that usually make transplant not possible

Flynn Butler, age 13, has lived his total life with out working intestines. Since delivery, he was out and in of hospitals, at all times tethered by medical traces that saved him alive. Due to his extraordinary household and a groundbreaking multi-organ transplant at Stanford Medicine Children’s Health, Flynn is lastly free to eat, transfer, and luxuriate in his life.

“He’s stronger now, extra energized, and completely satisfied,” says his mother, Rachel. “He’s actually excited to be taught to trip a motorcycle and skateboard along with his older brother, Logan.”

When Flynn was born, all the things appeared wonderful. Then, on his first night time dwelling he started projectile vomiting. His household took him again to the hospital close to their dwelling in Reno, Nevada, the place he was identified with intestinal malrotation—when the small gut doesn’t develop accurately throughout being pregnant and turns into twisted. That was the beginning of an extended, difficult journey to maintain Flynn alive.

“It has been horrible coping with this his total life,” Rachel says.

Throughout the next years, Flynn spent months at a time in hospitals and 12 to 14 hours a day related to an infusion pump to obtain IV vitamin known as total parenteral nutrition. It saved him alive, however it additionally saved him from attending college in individual or reaching common milestones, like studying find out how to trip a motorcycle.

When Flynn was 6 years previous, docs stated that his solely likelihood at survival was an intestinal transplant. He was referred to the Stanford Kids’s Pediatric Intestinal Transplant Program, one in all simply two intestinal transplant packages within the West. Stanford Kids’s is understood for caring for youngsters with extremely advanced wants, offering the newest modern care, and transplanting very sick youngsters and really tiny infants. To look after Flynn, they assembled a big staff of pediatric specialists.

Flynn arrived at Stanford Kids’s in tough form. He had a yeast an infection in his TPN line that had traveled to his lungs. “The superb docs at Stanford saved him. It took lots of work to assist him get well,” Rachel says.

TPN had scarred Flynn’s liver, turning his intestinal transplant right into a multi-organ transplant. He wanted an gut, liver, and pancreas, all from the identical donor, transplanted on the similar time.

Overcoming challenges to make transplant potential for Flynn

“Flynn had so many issues coming in that I doubt some other heart within the nation would have agreed to transplant him. Due to recurrent infections, he had misplaced all vascular entry for TPN besides one. He arrived with an entry level by way of his stomach, which isn’t commonplace and never perfect,” says Ke-You (Yoyo) Zhang, MD, pediatric gastroenterologist and medical director of the Pediatric Intestinal Transplant Program.

Throughout transplant surgical procedure, docs want open entry to wholesome arteries and veins to ship important fluids, together with TPN, medication, and electrolytes to maintain the kid alive.

“With out vascular entry, there isn’t a transplant, and no likelihood at life,” says Avnesh Thakor, MD, PhD, radiologist with the Pediatric Interventional Radiology staff at Stanford Kids’s.

Earlier than the care staff may even think about transplant, they needed to remedy the problem of vascular entry for Flynn. It appeared like a minor element, however transplant hinged on it, and his multidisciplinary care staff took time to contemplate an excellent method for Flynn so he would have the perfect consequence whereas he waited for transplant, and after.

“Each determination has short- and long-term penalties, and in a non-ideal state it takes the entire staff to determine it out. The back-and-forth between our many specialists solely occurs with belief and open communication. We depend on one another’s experience,” Dr. Thakor says. “Relating to medically advanced youngsters, our default is to say sure. That’s very distinctive. We ask: ‘What can we do to save lots of this baby?’”

Dr. Thakor used a number of modern approaches to salvage Flynn’s final remaining venous entry in his stomach. Flynn’s extremely difficult vascular anatomy required Dr. Thakor to very rigorously manipulate and information a specialised catheter (tube) in his remaining wholesome vein throughout a multi-hour process to maintain steady entry for fluids and TPN.

Ready for a multi-organ intestinal transplant

Flynn’s many issues meant a for much longer time on the transplant ready checklist. In complete, the household waited almost six years for the cellphone name that might change their lives. Dr. Zhang was with them each step of the way in which, serving to to coordinate Flynn’s many care providers and be sure that the household had all the things they wanted to look after him.

“Dr. Zhang was an enormous a part of Flynn’s care. She was his advocate and champion on all the things,” Rachel says.

Whereas within the hospital awaiting transplant, Flynn performed lots of video video games. His favourite is Pokémon. One among his nurses purchased him a Pokémon T-shirt, and lots of the nurses would come and play with him. He additionally loved drawing and different actions with Child Life and Creative Arts.

Rachel recommends Stanford Kids’s “100%.” “Everyone seems to be so competent and caring. They do all the things of their energy to ensure issues are performed the fitting means,” she says.

Getting the decision that donor organs have been accessible

The Stanford Kids’s care staff went the additional mile to make sure donor match for Flynn. They traveled to look at the donor organs to ensure they have been a wonderful match, which might make for a greater consequence.

“Once I obtained the decision, I nearly didn’t consider it. We had been ready for thus lengthy that I educated myself to not anticipate it,” Rachel says.

She’s going to always remember that day. Rachel was within the hospital in Las Vegas along with her husband, Eric Murphy, who had simply suffered a mini-stroke. The decision got here at 7 o’clock at night time.

“I observed my cellphone ringing and I used to be in shock. I stated to my mother-in-law, ‘It’s Stanford!’ and he or she stated, ‘Reply it!’ It had been so lengthy that when it lastly occurred, I panicked and felt excited and terrified on the similar time,” Rachel says.

That decision set off a whirlwind of exercise. Rachel and Flynn flew out early the subsequent morning, and Eric, who has been an enormous a part of Flynn’s care, did all the things he may to get there the next day.

Utilizing Flynn’s coronary heart in an modern method to ship important fluids throughout surgical procedure

Having an intestine-liver-pancreas transplant is a big ordeal in itself, however Flynn’s surgical procedure was difficult by needing to create one other entry level for fluids, moreover the entry in his stomach. Throughout such lengthy and sophisticated surgical procedures, numerous entry factors are wanted to handle quite a lot of fluids, together with vitamins, medication, electrolytes, and blood.

Due to Flynn’s a few years on TPN, almost all of his veins have been compromised, so his massive care staff needed to get artistic. First, they tried to determine entry within the backbone, with out success. Then, they turned to their Pediatric Heart Surgery colleagues.

“The intestinal transplant staff reached out to us and requested, ‘Are you able to assist in any means?’ and our staff mentioned it and stated, ‘Sure, we can provide you as many entry factors as you need,’” says Arvind Bishnoi, MD, pediatric coronary heart surgeon.

Dr. Bishnoi consulted with a number of members of his staff, together with Michael Ma, MD, chief of pediatric cardiac surgical procedure, to provide you with a singular plan, one that would possible be the primary for an intestinal transplant. As a result of all the physique’s blood goes to the fitting facet of the center, that’s the place the staff wanted to position the traces. Coronary heart surgeons usually place traces within the coronary heart for monitoring, however they’re small, and even small traces may cause scarring. But, to ship TPN and different fluids, the staff wanted to position a lot larger traces.

“Inserting massive traces straight into the center would have required making a big gap that might possible bleed once we eliminated the traces after surgical procedure. As an answer, we made a graft out of synthetic materials and sutured it on the center,” Dr. Bishnoi says. “We then positioned the traces by way of the graft, which may deal with the traces.”

A profitable intestine-liver-pancreas surgical procedure

Dr. Bishnoi was first up on Flynn’s surgical procedure day. He opened Flynn’s chest with a small incision so he may entry the center. Then, he positioned traces straight into the center. He was profitable, giving anesthesiologists loads of traces to ship important fluids to Flynn throughout his lengthy transplant surgical procedure.

“When we now have a tough case, we take it personally. We see ourselves as only one step in a plan that others can construct on. At Stanford Kids’s, we don’t discover excuses to keep away from doing one thing tough; fairly, we discover causes to do it,” Dr. Bishnoi says.

Performing a multi-organ intestinal transplant is a really lengthy and arduous course of. Kazunari Sasaki, MD, stomach transplant surgeon, performs tons of of transplants every year at Stanford, and he was a key member of Flynn’s surgical staff.

“Each multi-visceral (stomach organ) transplant may be very tough, however luckily Flynn’s surgical procedure was simpler than I anticipated, since his scar tissue was minimal. It went very easily,” says Dr. Sasaki.

Three transplant surgeons labored side-by-side throughout Flynn’s operation, together with Thomas Pham, MD, surgical director of Pediatric Kidney Transplant, and Stephan Busque, MD, interim director of Pediatric Liver Transplant. They have been capable of accommodate Flynn’s stomach central line, one thing the staff thought may need to be sacrificed throughout surgical procedure.

In the course of the operation, Dr. Sasaki needed to be extraordinarily centered to finish the surgical procedure in the course of the window when the donated organs have been most important, and to make sure minimal threat of bleeding. He rigorously positioned the brand new organs to realize an optimum match, which required meticulous stitching of Flynn’s veins and arteries to his new organs for good blood circulation. After the surgical procedure, his intestines turned pink instantly, and inside minutes his bowels started to contract, exhibiting they have been again to life and dealing.

“It took lots of modern, out-of-the-box pondering to provide you with plans that had by no means been performed earlier than: First, with Dr. Thakor from Interventional Radiology painstakingly working to take care of Flynn’s venous entry whereas he awaited transplant. Then, with our companions in coronary heart surgical procedure creating the modern method of inserting traces straight into the center,” Dr. Zhang says.

Flynn’s surgical procedure took 14 hours from begin to end. Whereas Rachel waited, she obtained common updates.

“When Dr. Zhang got here out after surgical procedure and informed me all of it went nicely, we each cried,” Rachel says. “All the pieces went fantastically—I don’t suppose it may have gone any higher.”

Flynn spent a number of weeks in intensive care, the place Dr. Bishnoi helped the nurses learn to deal with the distinctive traces in his coronary heart. The heart surgery team had deliberate for an choice that didn’t require a second coronary heart surgical procedure to take away the traces. Dr. Bishnoi was capable of take away them and suture the graft closed proper at Flynn’s bedside.

Flynn’s surgical procedure was in mid-September 2025, and remarkably he was dwelling by Thanksgiving. The Stanford Kids’s care team partnered carefully with Flynn’s native gastroenterology suppliers to assist him return dwelling early, and they’re nonetheless actively guiding his care right this moment.

“We have been shocked how briskly Flynn recovered. They ready us for a three-month hospital keep and spending six months close to the hospital as a result of the transplant was so advanced, however he recovered so shortly, and did so nicely, that there was no motive to maintain him there,” Rachel says.

Dwelling and digesting simply wonderful

Many infants who’re on TPN wrestle with studying to eat by mouth. Fortunately, Flynn was not one in all them, due to his household, who used a pacifier and inspired him to eat by way of the years, although the meals wouldn’t be digested or present vitamins. The primary time Flynn felt full after surgical procedure was a humorous shock for Rachel. He didn’t perceive the sensation.

“Flynn’s household deserves many of the credit score for his good consequence. From his first day of life, they’ve labored diligently, each single day, to look after him and his medical wants. They’re the one motive he was capable of survive by way of transplant,” Dr. Zhang says. “Rachel was his protected place, and he or she was a relentless by way of all the things.”

Rachel has simply completed nursing college. She was impressed to develop into a nurse from watching all of the nurses look after Flynn by way of the years. Flynn’s massive brother, Logan, and massive sister, Amelia, are thrilled to have Flynn dwelling and his transplant lastly behind him.

“They’ve at all times been there for Flynn; they’ve gone by way of a lot their total lives due to his medical issues,” Rachel says. “They usually have performed it with out ever turning into resentful or upset in regards to the further time and a focus Flynn wanted.”

Flynn not too long ago took an enormous step in his transplant journey. He and his stepdad, Eric, returned to Stanford Kids’s in March 2026 to have an ostomy takedown surgical procedure that closed his colostomy and reconnected his bowel, making it potential for stool to move usually. Gregory Tiao, MD, director of the Stanford Kids’s Pediatric Transplant Center and director of Pediatric Liver Transplant, carried out the takedown.

Dropping the colostomy bag was an enormous deal for Flynn, permitting him to lastly shed the final proof of his medical previous and step freely into his future.

“Not too long ago, my older son, Logan, introduced that 2026 was going to be 12 months for our household,” Rachel says. “He stated, ‘We have now been caught ready for Flynn’s surgical procedure, and so that you can get by way of nursing college, and now we will transfer ahead.’ I believe he’s proper.”

Learn more about intestinal transplant at Stanford Children’s >